Associate Degree in Nursing

The Chaffey College Associate Degree Nursing Program provides students with a high-quality education in a dynamic, supportive and engaging environment. The nursing curriculum at Chaffey College prepares the student to become an Associate Degree Nurse. Courses in natural, behavioral, and social sciences, as well as courses in communication skills provide a foundation for the nursing curriculum.  The program promotes a culture of educational excellence among a diverse student population in collaboration with healthcare partners that leads to:

• An Associate Degree in Nursing
• Licensure
• An entry-level professional registered nurse with the ability to utilize the latest healthcare technology while utilizing current evidence-based practice and clinical reasoning.
• The acquisition of the knowledge, skills, and attitudes to provide safe patient-centered care that meets the changing health care needs of diverse individuals, families, and communities.
• A desire for life-long learning
• Transfer or articulation to a Bachelor’s of Science in Nursing (BSN) program and beyond

The philosophy of the Chaffey College Associate Degree Nursing Program reflects the interrelationship between the four center metaparadigms of nursing (person, environment, health, and nursing), and incorporates the core values of the program outcomes of the Accreditation Commission for Education in Nursing (ACEN).  The philosophy of the program incorporates the competencies of the Quality and Safety for Education Nurses (QSEN) the core values of the National League of Nursing (NLN), and the Massachusetts Nurse of the Future (MNOF) competencies of communication and patient education.

Nursing
The essence of nursing is caring and compassionate patient-centered care.  Ethical standards that reflect a respect for individual dignity and consideration of cultural diversity are implicit in the practice of holistic patient-centered care. The nurse advocates for patients, families, communities and themselves in a way that promotes self-determination, integrity, and ongoing growth as human beings.  Nursing care is provided in collaboration with the patient, the family, and members of the health care team.  The nurse uses a spirit of inquiry and examines evidence that allows the quality of patient care to improve, and promotes safety while improving patient outcomes. Nursing judgment and clinical reasoning are integral in making competent decisions related to the provision of safe and effective nursing care. Communication of essential information is done by a variety of technical and human means as an essential part of nursing care. The adoption of these key philosophical components fosters the development of the professional identity of the nurse. 

The faculty is committed to excellence in the profession of nursing and quality education.  Nursing education takes place in collegiate and community health-care setting(s).  It is a process whereby students learn from a theoretical foundation based upon the humanities and principals from the biological, physical, and behavioral sciences.  As part of the application of clinical reasoning and clinical judegment and ADN program supports the application of the nursing process as defined by the American Nurses Association (ANA) as the first five standards of professional nursing process (2015). 

Illness, Wellness and the Individual
The faculty believes that each person is a unique individual influenced by his/her culture, ethnicity, sexual identity, socioeconomic status, and the environment in which he/she lives. One's behavior is motivated by basic needs that are common to all people. Wellness results when these needs are satisfied. Illness results when threats to one or more of the basic needs produce consequences that are beyond the individual's capacity to cope.

As part of the application of clinical reasoning and clinical judgement, the ADN program supports the application of the nursing process as defined by the American Nurses Association (ANA) to include the first five standards of professional nursing process (2015).   Those five steps are defined as assessment, diagnosis, outcomes/planning, implementation, and evaluation. 

Assessment: The nurse uses a systematic method to collect and code data about an individual as the first step in delivering nursing care. Assessment data includes physiological, psychological, sociocultural, spiritual, economic, and life-style information. For example, a nurse’s assessment of an individual in pain includes physical causes and behavioral responses to pain. The individual’s response to pain might include an inability to get out of bed, refusal to eat, withdrawal, expressed anger, or a request for pain medication. (ANA, 2015) Diagnosis. The nursing diagnosis is the nurse’s clinical judgement about the individual’s response to actual or potential health conditions or needs. The nursing diagnosis is the basis for the nurse’s plan of care utilizing language specific to nursing to describe specific problems. (ANA, 2015)

Outcomes/Planning: Based on assessment and diagnosis, the nurse sets measurable and achievable goals/desired outcomes for each person. Assessment data, nursing diagnosis, and goals are communicated to the interdisciplinary team and incorporated in the plan of care. (ANA, 2015)

Implementation: Nursing care is implemented according to the plan of care. Continuity of care for the individual receiving hospital or community-based healthcare services is essential to achieve optimal patient outcomes. (ANA, 2015)  Evaluation

The individual’s subjective and objective data are used to gauge the effectiveness of nursing care and are evaluated continually. The plan of care is modified as needed and the cycle then continues. (ANA, 2015).

Evaluation: The individual’s subjective and objective data are used to gauge the effectiveness of nursing care and are evaluated continually. The plan of care is modified as needed and the cycle then continues. (ANA, 2015).

The ADN program strives for the inclusion of students, faculty and staff from diverse backgrounds, and celebrates the unique viewpoints and experiences of the individual.  Faculty is responsive to the unique needs of each learner through the incorporation of the theories of adult learning and the attainment of self-efficacy. The faculty is committed to incorporating into their teaching methodology an awareness of individual differences of students including their cultural and ethnic backgrounds, learning styles, goals, and support systems The faculty strives to maintain a mutually beneficial relationship that values critical thinking and encourages flexibility for both the faculty and students in meeting the needs of the community.

Learning is the manner in which students attain knowledge, change their patterns of thought, attain skills and abilities, and develop professional identities (Billings & Halstead, 2020).   Teaching is the facilitation of learning and requires teachers and mentors who value the student and support their individual learning (Billings & Halstead, 2020). Learning is the responsibly of the student and is facilitated by faculty and curriculum through which the student constructs meaning from experience(s). Self-efficacy is the belief of the individual that they can complete a task successfully (Caprara et. al, 2008). Faculty facilitates students attainment of selfefficacy through active learning, in dynamic environments including clinical experiences, skills practice, simulations, and virtual learning.

The nursing program is grounded in the four core values of the NLN that serve as a foundation for practice as a professional nurse.  These core values include:

CARING: A culture of caring, as a fundamental part of the nursing profession, characterizes our concern and consideration for the whole person, our commitment to the common good, and our outreach to those who are vulnerable. All organizational activities are managed in a participative and person-centered way, demonstrating an ability to understand the needs of others and a commitment to act always in the best interests of all stakeholders (NLN, 2018). 

INTEGRITY: A culture of integrity is evident when organizational principles of open communication, ethical decision-making, and humility are encouraged, expected, and demonstrated consistently. Not only is doing the right thing simply how we do business, but our actions reveal our commitment to truth telling and to how we always see ourselves from the perspective of others in a larger community (NLN, 2018).

DIVERSITY: A culture of inclusive excellence encompasses many identities, influenced by the intersections of race, ethnicity, gender, sexual orientation, socio-economic status, age, physical abilities, religious and political beliefs, or other ideologies. It also addresses behaviors across academic and health enterprises. Differences affect innovation so we must work to understand both ourselves and one another. By acknowledging the legitimacy of us all, we move beyond tolerance to celebrating the richness that differences bring forth (NLN, 2018).

EXCELLENCE: A culture of excellence reflects a commitment to continuous growth, improvement, and understanding. It is a culture where transformation is embraced, and the status quo and mediocrity are not tolerated (NLN, 2018).

The philosophy of nursing education is illustrated by the integrating concepts from the National League of Nursing, the QSEN competencies and the values from Massachusetts Nurse of the Future (QSEN), which arise from the core values.  The integrating concepts include:

• Patient-Centered Care: The provision of compassionate, age, and culturally sensitive care that is based on a patient’s physiological, psychological, sociological, and spiritual needs as well as preferences, values and beliefs which respect the patient and designee to promote safe, quality care (Adapted from QSEN, 2007, MNOF 2010, NLN, 2010).
• Safety: The minimization of risk factors and errors of commission and omission that could cause harm to patient, self or others or delay patient recovery through individual, unit, or system performance (Adapted from QSEN, 2007, Giddens, 2017)
• Teamwork and Collaboration: The delivery of a coordinated approach to patient-centered care in partnership with the patient, other nurses, and team members fostering open communication, mutual respect, and shared decision making to achieve safe, quality care (Adapted from QSEN, 2007, Giddens, 2017).
• Informatics: The design, development use, and management of information science and technology as a communication and information management tool to direct care, mitigate errors, and support clinical decision making and evidence-based nursing practice (Adapted from QSEN, 2007, NLN, 2010).
• Evidence-Based Practice: The integration of best current evidence, clinical expertise, and patient involvement to guide nursing practice to achieve optimal patient-centered care (Adapted from MNOF 2010, Giddens 2017).
• Quality Improvement: The use of data and improvement methods consistent with current professional knowledge and evidence to monitor outcomes of care processes for the continuous improvement of health care services (Adapted from MNOF, 2010, NLN, 2010).
• Communication: The effective exchange of verbal and non-verbal information or messages between two or more people that promotes mutual respect and shared decision making with the goal of enhancing patient satisfaction and achieving optimal patient outcomes (Adapted from MNOF, 2010)
• Patient Education: The exchange of health-related information with patients and their designee that facilitates acquisition of knowledge and adoption of new behaviors that can be incorporated to improve health outcomes into everyday life (Adapted from Giddens, 2017).

Level 1: NURADN 7, 15, 28, 29
Outcome:  Implement nursing care to patients, families, and groups across the lifespan from diverse backgrounds in a variety of settings to ensure that it is compassionate, age and culturally appropriate, and based on a patient’s preferences, values, and needs.

Level 2: NURADN 35,39.46,49
Evaluate nursing care provided to patients, families, and groups across the lifespan from diverse backgrounds in a variety of settings to ensure that it is compassionate, age and culturally appropriate, and based on a patient’s preferences, values, and needs. 

Level 1: NURADN 7, 15, 28, 29
Outcome:  Participate as a member of the healthcare team in the provision of safe, quality, patient-centered care. 

Level 2: NURADN 35,39.46,49
Collaborate with members of the health care team to manage and coordinate the provision of safe, quality care for patients, families, and groups.

Level 1: NURADN 7, 15, 28, 29
Outcome:  Implement strategies that minimize risk and provide a safe environment for patients, self, and others in a variety of settings. 

Level 2: NURADN 35,39.46,49
Demonstrate effective use of strategies to mitigate errors and reduce the risk of harm to patients, self, and others in a variety of settings. 

Level 1: NURADN 7, 15, 28, 29
Outcome:  Utilize evidence-based information and patient care technology in the provision of safe, quality, patient-centered care.

Level 2: NURADN 35,39.46,49
Utilize evidence-based information and patient care technology to communicate relevant patient information, manage care, and mitigate error in the provision of safe, quality patient-centered care. 

Level 1: NURADN 7, 15, 28, 29
Outcome:  Identify best current evidence from scientific and other credible sources as a basis for developing individualized, patientcentered plans of care. 

Level 2: NURADN 35,39.46,49
Demonstrate use of best current evidence and clinical expertise when making clinical decisions in the provision of patient-centered care. 

Level 1: NURADN 7, 15, 28, 29
Outcome:  Participate in data collection processes that support established quality improvement initiatives. 

Level 2: NURADN 35,39.46,49
Utilize evidence-based quality improvement processes to effect change in the delivery of patient-centered care. 

Level 1: NURADN 7, 15, 28, 29
Outcome:  Utilize verbal and nonverbal communication strategies with patients, families, and groups from diverse backgrounds, and members of the healthcare team that enhance an effective exchange of information and development of therapeutic relationships. 

Level 2: NURADN 35,39.46,49
Enhance verbal and nonverbal communication strategies with patients, families, and groups from diverse backgrounds, and members of the healthcare team that enhance an effective exchange of information and development of therapeutic relationships. 

Level 1: NURADN 7, 15, 28, 29
Outcome:  Provide health-related information to patients, families, and groups that facilitate their acquisition of new knowledge and skills.

Level 2: NURADN 35,39.46,49
Provide health-related information to patients, families, and groups using varying teaching methods, which facilitate the acquisition of new knowledge and skills.

American Nurses Association, Inc. (2017). The nursing process. Retrieved from https://www.nursingworld.org/practicepolicy/workforce/what-is-nursing/the-nursing-process/

Billings, D. M., & Halstead, J. A. (2020). Teaching in nursing: A guide for faculty (6th ed). Saint Louis, MO: Elsevier

Caprara, G.V., Fida, A., Vecchionem, M., Del Bove, G., Vecchio, G.M., Barbaranelli, C., & Bandura, A. (2008). Longitudinal analysis of the role of perceived efficacy for self-regulated learning in academic continuance and achievement. Journal of Educational Psychology, 100, 525-534.

Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., . . . Warren, J. (2007). Quality and safety education for nurses. Nursing Outlook, 55(3), 122-131.

Giddens, J. F. (2017). Concepts for Nursing Practice (2nd ed.). St Louis, MO: Elsevier.

National League for Nursing (NLN) (2010). Outcomes and competences for graduates of practical/vacation, diploma, associate degree, baccalaureate, master’s, practice doctorate, and research doctorate programs. New York, New York: NLN.

National League for Nursing (NLN) (2018). Core values. Retrieved from:  http://www.nln.org/about/corevalues.

Massachusetts Nurse of the Future (MNOF) (2010). Massachusetts Nurse of the Future nursing core competencies. Retrieved from:  http://www.mass.edu/nahi/documents/NursingCoreCompetencies.pdf